The incidence of the bronchial rupture following blunt chest trauma has increased gradually with the increases of traffic accident and mechanization. We have experienced the 3 cases of the bronchial rupture following blunt chest trauma. The first case was a 38 year old man who was compressed into a blank wall by fork-lift. He complained of severe dyspnea with air leak through the chest tube and right pneumothorax with collapsed lung was seen in his chest X-ray film after closed thoracostomy. Emergency bronchoscopy showed disruptions of the right upper lobar bronchus and the membranous portion of the intermediate bronchus. The second was 8 year old boy who was sustained a crushing chest injury by bus. He also complained of severe dyspnea with air leak through the chest tube and right pneumothorax with collapsed lung was seen in his chest X-ray film after closed thoracostomy. We performed the computed tomogram of the chest and found the bronchial rupture at the distal portion of the right main bronchus. The third case was 40 year old male who was sustained a crushing chest injury by in-car accident. He complained of mild dyspnea without air leak through the chest tube and the left lung was well expanded in his chest X-ray film after closed thoracostomy. Bronchoscopy showed disruption of the 6th cartilaginous portion of the left main bronchus. Emergency bronchoplasties were performed with interrupted end-to-end anastomosis in all cases. Postoperative air leak occurred for 7 days in the third case. Others were uneventful.
Accidents, Traffic ; Adult ; Bronchi ; Bronchoscopy ; Chest Tubes ; Child ; Dyspnea ; Emergencies ; Humans ; Incidence ; Lung ; Male ; Pneumothorax ; Rupture* ; Thoracic Injuries ; Thoracostomy ; Thorax* ; X-Ray Film

Using immunohistochemical methods, the authors investigated the distribution of tubulin in normal skin and 31 skin tumors, including 11 benign skin tumors and 20 malignant skin tumors, In normal skin, tubulin was strongly expressed in basal cells of the epidermis, sebaceus celis and dermal nerves. Myoepithelial cells, ductalI cells of sveat ducts and outer root sheath cells of hair follicles stained moderat,ely. Lermal fi broblasts showed no staining. In benign tumors including keratoacanthoma, trichoepithelioma, and nevocellular nevus the strornal fibroblast.s were entirely tubulin negative as well as the turnor cells. In basal cell carcinoma, the stromal fibroblasts were negative',whereas tumor cells were weakly positive. In squarnous cell carcinoma(SCC), tumor cells weri, tubulin positive weakly, the degree of tubulin expression of its stroma1 fibroblasts tencied to be in proportional to the grade of malignanr.u. Tumor cells of malignant melanoma and nevocellular nevus were tubulin positive moderately bist the stromal fibrobla.sts were strongly positive only in the cases of malignant melanoma. These results show that the degree of the tubulin; expression in adjacent, stromal cells of epidermal tumors is in proportiona.l to that of their malignancy, These suggest that the expression of tubulin in fibroblasts surrounding tumor cells of malignant melanoma and SCC reflects a stromal alt,eration that might contribute to tumor in vasion, and play a role for cellular motility.
Carcinoma, Basal Cell ; Epidermis ; Fibroblasts ; Hair Follicle ; Keratoacanthoma ; Melanoma ; Nevus ; Skin* ; Stromal Cells ; Tubulin*

No abstract available.
Echocardiography* ; Humans ; Infant, Newborn*

Atypical fibroxanthoma(AFX) occurs most on sun-exposed area of the head and neck of elderly person. It has an excellent prognosis after conservative, but complete, excision. However, because of its potential, albeit small, for metastasis, it is widely regarded as a low-grade sarcoma. We present herein two cases of atypical fibroxanthoma. The case 1 was a 86-year-old female who had a small egg-sized, dome shaped nodule with eroive surface on the left cheek. The other case was a 60-year-old male who had solitry bean-sized, nodulo-ulcerative lesion on the vertex. Immunohistochemical studies revealed positive reaction for vimntin and a-antichymo trypsin. These patients have received completely total surgical ecis on and remained free of recurrence for a period of about, 2 years follow up.
Aged ; Aged, 80 and over ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Sarcoma ; Skin* ; Trypsin

No abstract available.

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions. ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions. The results were as follows ; 1) The mean ADA activities assessed in pericardial effusions were 134.0+/-77.6U/L in group A : 93.8+/-43.8 in group B : 38.3+/-23.2 in group C : 27.3+/-20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level. 2) The mean ADA activities assessed in sera were 50.7+/-57.2 U/L in group A : 63.5+/-24.1 in group B : 25.9+/-12.0 in group C : 14.0+/-7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference. 3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered. In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Inosine ; Pericardial Effusion* ; Pericarditis, Tuberculous

No abstract available.
Blood Platelets* ; Blood Transfusion*

We report herein a case of pseudoxanthoma elasticum(PXE) in a 24 year old woman. She had a generalized laxity of the skin which tended to hang in folds along the sides of the trunk and in the axillary areas. There was no similar skin lesion in her family. Histopathological examination revealed clumping and fragmentation of the elastic fibers in the mid and lower dermis. Von Kossa stain showed dense deposition of calcium in these areas. We suspect this case as autosomal recessive type II PXE.
Calcium ; Dermis ; Elastic Tissue ; Female ; Humans ; Pseudoxanthoma Elasticum* ; Skin ; Young Adult

A 12-year-old boy developed cholestatic hepatitis with Steven-Johnson syndrome following the use of amoxicillin. The skin lesion and general condition were improved over 2 weeks, but jaundice was gradually aggrevated. We performed liver biopsy, on 30th hospital day, which showed cholestatic hepatitis. The patient improved gradually and liver function was normalized 5 months later.
Amoxicillin ; Biopsy ; Child ; Hepatitis* ; Humans ; Jaundice ; Liver ; Male ; Skin

We report two cases of dyschromatosis symmetrica hereditaria. One is a 12-year- old female and her family had five individuals with similar pigmentary disorder through three generation. The other is a 22-yesr-old female who had no family history of similar disease. Fontana-Masson stain revealed increased and decreased melanin granules in the basal cell layers in the pigmented and depigmented lesions respectively.
Female ; Humans ; Melanins